Prevention of mother-to-child transmission and voluntary counseling and testing programme data: what is their utility for HIV surveillance?
Prevention of mother-to-child transmission and voluntary counseling and testing programme data: what is their utility for HIV surveillance?
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DOI：
10.1097/01.aids.0000172873.82509.5e
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发表时间：
2005-05-01
期刊：
影响因子：
3.8
通讯作者：
Marum, LH
中科院分区：
文献类型：
--
作者：
Hladik, W;Masupu, K;Marum, LH
目的：在未经知情同意的情况下，通过非关联匿名检测（UAT）进行基于产前诊所（ANC）的艾滋病毒监测，为资源有限、流行病普遍存在的国家提供可靠的长期趋势数据。预防母婴传播 (PMTCT) 和自愿咨询和检测 (VCT) 计划的迅速扩展引发了人们对它们在 HIV 监测中的效用以及它们取代基于 UAT 的 ANC 监测的潜力的疑问。 方法：在最近的一次国际会议上提出了关于使用 PMTCT 或 VCT 数据进行 HIV 监测的四场演讲。本文介绍了主要发现，并考虑了使用 PMTCT 或 VCT 数据进行监测的操作和流行病学方面。结果：乌干达的 VCT 数据证实了 ANC 监测中观察到的 HIV 流行率下降趋势。泰国是一个拥有全国 PMTCT 覆盖率且对 HIV 检测接受度非常高的国家，已取代 UAT 数据，转而采用 PMTCT 数据进行监测。博茨瓦纳和肯尼亚的研究表明，基于 PMTCT 的 HIV 患病率相似，但 PMTCT 数据的质量和可用性各不相同。结论：UAT 的优势在于不存在选择偏差和个人数据的可用性。相反，VCT和PMTCT项目测试数据的数量往往超过UAT，但可能会因自我选择或拒绝测试而产生偏差。当使用 VCT 或 PMTCT 数据进行监测时，调查人员必须考虑这些注意事项，以及不同的数据质量、可访问性和个人记录的可用性。
Objective: Antenatal clinic (ANC)-based surveillance through unlinked anonymous testing (UAT) for HIV without informed consent provides solid long-term trend data in resource-constrained countries with generalized epidemics. The rapid expansion of the prevention of rnother-to-child transmission (PMTCT) and voluntary counseling and testing (VCT) programmes prompts the question regarding their utility for HIV surveillance and their potential to replace UAT-based ANC surveillance.Methods: Four presentations on the use of PMTCT or VCT data for HIV surveillance were presented at a recent international conference. The main findings are presented in this paper, and the operational and epidemiological aspects of using PMTCT or VCT data for surveillance are considered.Results: VCT data in Uganda confirm the falling trend in HIV prevalence observed in ANC surveillance. Thailand, a country with nationwide PMTCT coverage and a very high acceptance of HIV testing, has replaced UAT data in favor of PMTCT data for surveillance. Studies from Botswana and Kenya showed that PMTCT-based HIV prevalences was similar, but the quality and availability of the PMTCT data varied.Conclusion: The strength of UAT lies in the absence of selection bias and the availability of individual data. Conversely, the quantity of VCT and PMTCT programme testing data often exceed those in UAT, but may be subject to bias due to self-selection or test refusal. When using VCT or PMTCT data for surveillance, investigators must consider these caveats, as well as their varying data quality, accessibility, and availability of individual records.